Studies Support Yoga for Chronic Back Pain

A 12-session, 3-month yoga program led to greater improvements in back function than usual care in patients with chronic low back pain, says a Medscape Medical News article based on a study published November 1 in Annuals of Internal Medicine. However, yoga did not yield greater reductions in pain or improvements in overall health compared with usual care.

The study involved 313 adults with chronic or recurrent low back pain. All of them received a back pain education booklet and usual care. In addition, 156 were offered Iyengar yoga classes (12 classes total, once weekly). The yoga classes were given by 12 yoga teachers who had extra training in back care. Each class lasted 75 minutes.

Sixty percent of patients in the yoga group attended at least 3 of the first 6 sessions and at least 3 other sessions. In the first 3 months, 82% said they practiced yoga at home on their own, 65% were practicing yoga at home at 6 months, and 60% were practicing yoga at home at 12 months. At baseline, yoga and usual care group participants had mean Roland-Morris Disability Questionnaire (RMDQ) scores of 7.84 and 7.75, respectively. The researchers report that the yoga group had better back function at 3 months (the primary outcome) and at 6 and 12 months (secondary outcomes) than the usual care group, says Medscape.

The yoga and the usual care groups had similar back pain and general health scores at 3, 6, and 12 months, and the yoga group had higher scores on the Pain Self-Efficacy Questionnaire at 3 and 6 months, but not at 12 months.

The study notes that data were missing for the primary outcome for 21 yoga participants and 18 usual care participants, and differential missing data were observed (more so in the yoga group) for secondary outcomes.

Additional support for yoga in chronic back pain comes from a study published online October 24 in the Archives of Internal Medicine. As reported byMedscape, the study found that stretching, regardless of whether it is achieved via yoga classes or conventional stretching exercises, has moderate benefits in adults with moderately impairing chronic low back pain.

In this comparative effectiveness study, the researchers found that yoga classes were more effective than a self-help book, but not more effective than stretching classes, in improving function and reducing symptoms resulting from chronic low back pain, with benefits lasting at least several months.

Comments

"Usual care" was not defined in this study, but as it was run out of primary care offices could likely be anything from "wait and see", to meds, to PT.
The potential for a Hawthorne effect was huge! Data from Table 1 indicated 99% of the subjects (including 100% of subjects in the Usual Care group) expected yoga to work.

Posted by Pete Blanpied
on 11/4/2011 2:48 PM

It is probable that most PTs today know the benefits of appropriate
yoga-based exercises as we have taught these techniques to our
patients for decades. Even a cursory review of the myriad
exercise protocols familiar to most, if not all clinicians, would
certainly illustrate the relationship of physical therapy to a variety of yoga disciplines. However, patients need and expect a thorough
evaluation of their movement, pain, and functional problems
before a plan of care - which may or may not include therapeutic
exercise- is initiated.
question, patients are

Posted by Herschel Budlow
on 11/5/2011 10:29 PM

I agree with the above comments. I'm glad that it shows that yoga can work, but without better review of what it's compared to it's difficult to make detailed decisions based off of this.

Posted by Nick Rainey
on 11/8/2011 2:27 PM

Yoga is one of the best exercises to increase flexibility and help reduce back pain.
As a back pain suffered myself, I can testify that exercising (especially Yoga) helps